Comparison between sequential transfer vs. day 3 and day 5 frozen embryo transfer in IVF patients

Rohan Palshetkar; Mayuri More; Nandita Palshetkar; Hrishikesh Pai; Rishma Pai; Arnav Pai

doi:10.18203/2320-1770.ijrcog20233638

Authors

Rohan Palshetkar Department of Obstetrics and Gynecology, D. Y. Patil Medical College, Navi Mumbai, Maharashtra, India https://orcid.org/0000-0001-5359-2765
Mayuri More Department of Obstetrics and Gynecology, D. Y. Patil Medical College, Navi Mumbai, Maharashtra, India
Nandita Palshetkar Bloom IVF, Mumbai, Maharashtra, India
Hrishikesh Pai Bloom IVF, Mumbai, Maharashtra, India
Rishma Pai Bloom IVF, Mumbai, Maharashtra, India
Arnav Pai Bloom IVF, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2320-1770.ijrcog20233638

Keywords:

Blastocyst transfer, Implantation rate, Sequential transfer, ART, Embryo transfer

Abstract

Background: Sequential embryo transfer is when both cleavage-stage embryo is transferred on day 3 and blastocyst is transferred on day 5, sequentially in the same cycle. This has been suggested for increasing embryo implantation rate. Sequential transfer gives benefit of both day 3 as well as day 5 transfer in the same cycle, giving better outcome in patients suffering infertility. This study compares the implantation rates in sequential transfer vs Day 3 and day 5 transfers.

Methods: This multi-centric study is a retrospective study conducted over a period of one year at D. Y. Patil Fertility Centre, Navi Mumbai. Total of 432 transfers were conducted in patients, out of which 262 were Day 3 or cleavage stage embryo transfer, 109 were Day 5 or blastocyst embryo transfer and 61 were sequential embryo transfer.

Results: Day 3 transfer group had the clinical pregnancy rate of 52.67%, whereas day 5 transfer group had 60.55% of clinical pregnancy positive cases. Sequential embryo transfer had implantation rate of 60.66%, which was slightly higher than day 5 (60.55%) and day 3 (52.67%) implantation rates.

Conclusions: Sequential transfer has marginally increased rate of implantation and clinical pregnancy when compared to day 5 and day 3 transfers.

Metrics

Metrics Loading ...

References

Fukui A, Funamizu A, Yokota M. Uterine and circulating natural killer cells and their roles in women with recurrent pregnancy loss, implantation failure and preeclampsia. J Reprod Immunol. 2011;90(1):105-10.

Simon A, Laufer N. Assessment and treatment of repeated implantation failure (RIF). J Assist Reprod Genet. 2012;29(11):1227-39.

Graham ME, Jelin A, Hoon AH, Wilms Floet AM, Levey E, Graham EM. Assisted reproductive technology: Short‐and long‐term outcomes. Develop Med Child Neurol. 2023;65(1):38-49.

Simon A, Laufer N. Assessment and treatment of repeated implantation failure (RIF) J Assist Reprod Genet. 2012;29:1227-39.

Awonuga AO, Camp OG, Abu-Soud HM, Rappolee DA, Puscheck EE, Diamond MP. Determinants of Embryo Implantation: Roles of the Endometrium and Embryo in Implantation Success. Reprod Sci. 2023; 29:1.

Lu X, Liu S, Dong X. Research progress of two-step sequential embryo transfer strategy in in vitro fertilization-embryo transfer cycles. Chin J Reprod Contracept. 2018;38(4):333-6.

Guerif F, Bidault R, Gasnier O. Efficacy of blastocyst transfer after implantation failure. Reprod Biomed Online. 2004;9(6):630-6.

Levitas E, Lunenfeld E, Har-Vardi I. Blastocyst-stage embryo transfer in patients who failed to conceive in three or more day 2-3 embryo transfer cycles: a prospective, randomized study. Fertil Steril. 2004; 81(3):567-71.

Marek D, Langley M, Gardner DK, Confer N, Doody KM, Doody KJ. Introduction of blastocyst culture and transfer for all patients in an in vitro fertilization program. Fertil Steril. 1999;72:1035-40.

Glujovsky D, Farquhar C, Retamar AM, Sedo CR, Blake D. Cleavage stage versus blastocyst stage embryo transfer in assisted reproductive technology. Cochrane Database Syst Rev. 2016;6:CD002118.

Gardner DK, Vella P, Lane M, Wagley L, Schlenker T, Schoolcraft WB. Culture and transfer of human blastocysts increases implantation rates and reduces the need for multiple embryo transfers. Fertil Steril. 1998;69(1):84-8.

Nadkarni PK, Nadkarni KM, Singh PP, Singh P, Nadkarni A, Kalyani KR, et al. A comparative study of pregnancy outcome of sequential versus day 3 versus only blastocyst (day 6) transfer at a single IVF center over one year. Int J Reprod Contracept Obstet Gynecol. 2015;4:2032-5.

Haitham T, Ali A, Ahmed H, El-Sayed D, Rania A, Mona R, et al. Comparing sequential vs day 3 vs day 5 embryo transfers in cases with recurrent implantation failure: randomized controlled trial. JBRA Assist Reprod. 2021;25(2):185-92.

Dalal R, Mishra A, Pai HD, Palshetkar N. A prospective trial comparing sequential day 3/day 5 transfer with cleavage stage transfer and blastocyst stage transfer. IVF Lite. 2015;2:30-6.

Goto S, Takebayashi K, Shiotani M, Fujiwara M, Hirose M, Noda Y. Effectiveness of 2-step (consecutive) embryo transfer. Comparison with cleavage-stage transfer. J Reprod Med. 2003;48:370-4.

Craciunas L, Gallos I, Chu J, Bourne T, Quenby S, Brosens JJ, et al. Conventional and modern markers of endometrial receptivity: a systematic review and meta-analysis. Human reproduction update. 2019;25(2):202-23.

Shapiro BS, Daneshmand ST, Garner FC, Aguirre M, Hudson C, Thomas S. Evidence of impaired endometrial receptivity after ovarian stimulation for in vitro fertilization: a prospective randomized trial comparing fresh and frozen–thawed embryo transfer in normal responders. Fertil Steril. 2011;96(2):344-8.

Phillips SJ, Dean NL, Buckett WM, Tan SL. Consecutive transfer of day 3 embryos and of day 5-6 blastocysts increases overall pregnancy rates associated with blastocyst culture. J Assist Reprod Genet. 2003;20:461-4.

Levron J, Shulman A, Bider D, Seidman D, Levin T, Dor J. A prospective randomized study comparing day 3 with blastocyst- stage embryo transfer. Fertil Steril. 2002;77:1300-1.

Blake DA, Farquhar CM, Johnson N, Proctor M. Cleavage stage versus blastocyst stage embryo transfer in assisted conception. Cochrane Database Syst Rev. 2007;4:CD002118.

Abramovici H, Dirnfeld M, Weisman Z, Sorokin Y, Lissak A, Rofe A, et al. Pregnancies following the interval double-transfer technique in an in vitro fertilization- embryo transfer program. J In Vitro Fert Embryo Transf. 1988;5:175-6.

Al-Hasani S, van der Ven H, Diedrich K, Reinecke A, Hartje H, Krebs D. Effect of sequential embryo transfer on pregnancy following in vitro fertilization. Geburtshilfe Frauenheilkd. 1990;50:640-3.

Ashkenazi J, Yoeli R, Orvieto R, Shalev J, Ben-Rafael Z, Bar-Hava I. Double (consecutive) transfer of early embryos and blastocysts: aims and results. Fertil Steril. 2000;74:936-40.